Helping children cope

Helping children adjust and cope when a family member has cancer, whether it’s a sibling, a parent or grandparent, is challenging. It can be especially hard for kids if their routines have to change or if the person with cancer looks or acts differently or is in the hospitaI.

Having cancer can make being a parent even more demanding and challenging. The symptoms and side effects of cancer and its treatment can make it hard to care for young children, while the parents of teens may find things challenging because they have to ask their teens to take on more responsibility at home at a time when teens are trying to break away from and establish more independence from the family.

Many parents are tempted to try to hide a cancer diagnosis from children in order to prevent them from being scared or worrying. But even very young children can sense if something is wrong. If they hear the news from someone else, this can affect their trust in you, and they may also think that the situation is worse than it is. In general, an open and honest approach with your child about cancer, using language that is appropriate for their level of understanding, is best. Encourage your children to ask questions and do your best to answer them. Doing this can:

help your child cope

make them feel a part of the cancer journey

strengthen your family bond

It can be hard to know how much information to share. Share enough about the situation that children are not caught unaware but don’t say so much that children feel anxious for too long about things that may or may not happen in the future. Treatment centres may offer programs that can help your child cope.

Children react and cope differently to a parent having cancer depending on their age and maturity level.

Infants and very young children (0–3 years)

Infants and very young children cannot understand the disease of cancer. At best, they might understand that someone is sick, doesn’t feel well or needs to have medicine. For children this age, their biggest fear is being separated from their parents, and any change in routine is very disruptive. To help children this age cope, you can:

Comfort them with cuddles and hugs.

If you’ll be away from home, reassure them that you will be home as soon as you can.

Arrange short visits to see a parent who has to be in the hospital.

Maintain a normal daily routine as much as you can. Ask relatives, friends or daycare staff to help.

Try to have a parent spend time with them every day. If you can’t physically be with them, try to phone them. Read them their favourite story over the phone or sing them a lullaby, or leave a recorded message, story or lullaby that they can listen to.

Tell them how much you miss them and love them.

Preschool children (3–5 years)

Preschool children understand cancer when explained in simple terms. They may look for a specific cause for your cancer, such as something they did or they thought, so it’s important to reassure them that they did not cause your cancer.

Explain your cancer using simple terms, and reassure them that people are helping you get better.

Comfort them with cuddles and hugs.

If you will be away from home, reassure them that you will be home as soon as you can.

Maintain a normal daily routine as much as you can. Ask relatives, friends or daycare staff to help.

Try to have one parent spend time with them every day. If you can't physically be with them, try to phone them. Tell them how much you miss and love them.

Let them help with simple tasks such as picking out a toy or book to take to the hospital to make them feel more involved.

School-age children (6–12 years)

School-aged children understand a more detailed explanation of cancer. Some children this age may be concerned that cancer is contagious. They may also fear a parent will die or stay sick for a long time. They may worry about physical changes to you or separation from you. They may feel guilty about having fun when someone they love is sick. Children this age may hear lots about cancer through friends, school, television and the Internet.

Give understandable explanations of the diagnosis and the treatment you are having in the hospital and how you are feeling.

Reassure the child that cancer is not contagious and they will not catch it.

Encourage your child to talk to you and ask questions. Answer the questions honestly – admit if you don’t know the answer, and try to find the answer.

Talk about normal feelings of fear, worry, sadness and anger. Explore acceptable ways those feelings can be expressed. Share how you are feeling and how you express your feelings.

Encourage them to maintain contact with you in the hospital through letters, emails, telephone calls and messages, drawings, cards and visits when possible.

Tell teachers and coaches so that they can help and support your child.

Maintain a normal daily routine as much as you can. Ask neighbours, friends and other parents to take your child to after-school activities. Keeping children on their regular schedule keeps them busy and maintains a sense of normalcy.

Reassure children that it’s okay and healthy to have fun.

When possible, let children help make decisions about things that affect them, such as whose house they can go to after school or which parent should come to their hockey game. This helps them maintain a sense of control and reassures them that their opinions count.

Let them feel helpful by encouraging them to do small chores like washing dishes or dusting, or even drawing you a picture or keeping you company while you watch a movie.

Try to have one parent spend time with them every day. If you can't physically be with them, phone or text them and focus solely on them – what their day was like, how a test went, how their soccer game was and so on.

Tell them how much you miss and love them.

Teenagers (13–18 years)

Teenagers understand a complex explanation of cancer and may have many detailed questions. Teenagers will likely worry more than younger children about how your cancer will affect them and the entire family. They may worry about the financial impact that cancer will have on the family or they may worry about how younger siblings will cope. Teens may hear lots about cancer through friends, school, television and the Internet.

Provide detailed explanations of the diagnosis, treatment and side effects, and how you are feeling. Tell them as much as they want to know about cancer and the situation. Ask for their opinions and, if possible, let them help you make decisions. Arrange conversations with the healthcare team if the teen feels that this would help.

Encourage your teen to share any information they learn and discuss it together. Tell them it’s okay for them to ask any questions. Answer all questions honestly – admit if you don't know the answer, and try to find the answer. They may need to hear that cancer treatment is very individual as sometimes reading information online or talking to friends can provide them with misinformation.

Reassure teens that you will work through this crisis as a family.

Encourage teens to talk about their fears and feelings of fear, worry, sadness and anger. Be patient. Teens may not have the words or the ability to express emotions like anger, guilt or grief – they may resort to moodiness or outbursts instead. Explore acceptable ways of expressing those feelings.

Talk about how you’re feeling and share how you work through your feelings.

Let them help out at home because this helps them feel useful, but be careful not to overburden them with too much responsibility. Let them know how much you appreciate their help.

Try to make sure the teenager gets a break from the situation at home. This might be spending time with friends or having a regular night out for movies or pizza.

Encourage teens to stay involved at school and other activities they enjoy. They need to know that it’s okay to have fun despite your illness.

Encourage teens to maintain contact with you in the hospital through letters, cards, emails, telephone calls, recorded messages, pictures and visits.

Ask your teen how much information they want shared with their school. Telling a trusted teacher or coach about the situation may help, and they can offer extra support to your child.

Ask how their friends have reacted to the news of cancer in the family. Do your best to help them with any awkward situations that have happened. Friends can be a great source of support, especially those who have also dealt with serious illness.

Maintain a normal daily routine as much as you can. Ask neighbours, friends and other parents to take your teen to after-school activities. Keeping children on their regular schedule keeps them busy and maintains a sense of normalcy.

Try to have one parent spend time with them every day. If you can't physically be with them, phone or text them and focus solely on them – what their day was like, how a test went, how their soccer game was and so on.

Ask a relative or friend to spend some special time with them.

Maintain contact with them at home by phoning or texting. Teens are often more comfortable talking at home or in a private setting. When sharing information over a cellphone, make sure the teen is in a comfortable place, especially if sharing difficult news.

Despite your best efforts to help your child cope, teenagers may still struggle. Don’t blame yourself. Other family members, teachers, coaches and spiritual leaders can also help teens through this time. Find out if there is a support program in the community for teens whose family members have cancer. Seek professional help through the psychosocial team at the hospital. These people are trained to help children going through these situations, and your children may feel more freedom to open up to someone who isn’t directly involved in the family.